<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">
<%@ page contentType="text/html; charset=utf-8" import="com.*"%>
<html xmlns="http://www.w3.org/1999/xhtml">
  <head>
	    <title>补卡发卡登记</title>
	    <meta http-equiv="content-type" content="text/html; charset=UTF-8" />
	    
	    <script src="${pageContext.request.contextPath }/scripts/boot.js" type="text/javascript"></script>
	   <style type="text/css">
    	
	    </style> 
	
  </head>
  
  <body>
   <form id="form1" method="post">
 	 <!-- ============================== 第一部分 详细信息================================================== -->
 	 <fieldset style="border:solid 1px #aaa;height:100%;width:98%;">
 	  	<legend>个人发放</legend>
 	  		<div style="width:100%;">
 	  			<table style="width:100%;" cellpadding="5">
 	  				<tr style="width:100%;">
 	  					<td style="width:10%;text-align: right;">社会保障卡号:</td>
 	  					<td style="width:15%;"><input id="aac001" name="aac001" class="mini-textbox" emptyText="请输入社保号..." style="width:100%;"/></td>
 	  					<td style="width:10%;text-align: right;">劳动保障证号:</td>
 	  					<td style="width:15%;"><input id="ldbzh" name="ldbzh" class="mini-textbox"  style="width:100%;"/></td>
 	  					<td style="width:10%;text-align: right;">制卡批次:</td>
 	  					<td style="width:15%;"><input id="aaz001" name="aaz001" class="mini-textbox" " style="width:100%;"/></td>
 	  					<td style="width:25%;"></td>
 	  				</tr>
 	  				<tr style="width:100%;">
 	  					<td style="text-align: right;">姓名:</td>
 	  					<td><input id="aac003" name="aac003" class="mini-textbox"  style="width:100%;"/></td>
 	  					<td style="text-align: right;">性别:</td>
 	  					<td><input id="aac004" name="aac004" class="mini-combobox"  style="width:100%;"/></td>
 	  					<td style="text-align: right;">盒号:</td>
 	  					<td><input id="aaz632" name="aaz632" class="mini-textbox"  style="width:100%;"/></td>
 	  				</tr>
 	  			</table>
 	  		</div>
 	 </fieldset>
 	 
 	 <!-- ============================== 第三部分 按钮================================================== -->
 	 <br/>
	    <div>
	    	<table style="table-layout:fixed;width:100%;" cellpadding="0" cellspacing="10">
	    		 <tr style="width:100%;">
	    		 	 <td style="width:35%;"></td>
				     <td style="width:5%;white-space:nowrap;"><a class="mini-button" onclick="" enable="false" style="width:100%;"><span  style="text-decoration:underline">Q</span>.确认</a></td>
			     	 <td style="width:5%;white-space:nowrap;"><a class="mini-button" onclick="" enable="false" style="width:100%;"><span  style="text-decoration:underline">R</span>.清屏</a></td>
				     <td style="width:35%;"></td>
	    		</tr>
	    	</table>
	    </div> 
   </form> 
  </body>
</html>
